Journal of Nephrology & Therapeutics

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

Abstract

Metin Sarikaya*,Feyza Bora,Ayca İnci,Funda Sari,Semih Gul,Refık Olmaz

Purpose: Among patients end-stage renal disease who receive peritoneal dialysis, malnutrition is an strong predictor of increased morbidity and mortality rates. In cases with malnutrition, hypoalbuminemia occurs mainly due to the leakage of albumin through peritoneal membrane. Therefore, the current study aimed to investigate and compare the effects of intraperitoneal or oral amino acid supplements in preventing hypoalbuminemia. 1.2 1.2

Method: Our study included 36 patients on continuous ambulatory peritoneal dialysis (CAPD) in our center. In one group, one of the exchanges was replaced with a daily dose of 2000ml of peritoneal dialysis solution with 1.1% amino acids (AAs). The other group was given oral supplementation of keto/amino acids. The group receiving intraperitoneal (IP) AAs was composed of 16 patients, while oral keto/amino acid group included 20 patients. The baseline levels of serum albumin, prealbumin, transferrin, CRP, CO2, cholesterol panels and weights (recorded during PET) were compared with the values measured after 6 months of treatment.

Results: The baseline albumin levels in the IP AA group were lower than the Oral AA group (p=0.008). When we categorized the patients based on their peritoneal membrane permeability, we found no difference between the peritoneal membrane permeability values of the groups and their laboratory variables (p>0.05). At the end of month 6, the BUN levels significantly elevated in the group receiving IP AA solution, whereas their levels of phosphorus and HDL declined (p <0.05). The group receiving oral AAs supplement had lower levels of albumin and HbA1C at the end of month 6 (p <0.05).

Conclusion: Although treatment with AAs supplements administered either intraperitoneally or orally, can be considered a good nutritional support, it should be borne in mind that the important point is to increase the amount of dietary protein intake in individual patients.